Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center
Background. Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2021/4731013 |
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| author | Waleed Mohamed Fadlalla Ayman Hanafy Mahmoud Abdelhakim Hatem Aboulkassem El Sayed Ashraf Ahmed Abdelbary |
| author_facet | Waleed Mohamed Fadlalla Ayman Hanafy Mahmoud Abdelhakim Hatem Aboulkassem El Sayed Ashraf Ahmed Abdelbary |
| author_sort | Waleed Mohamed Fadlalla |
| collection | DOAJ |
| description | Background. Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. Methodology. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications. Results. LRC was associated with less hospital stay (9.8 vs. 13.8 days, P=0.001), less time to oral solid intake (6 vs. 8.6 days, P=0.031), and lower opioid requirements (23.3% vs. 53.3%, P=0.033). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable. Conclusion. Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve. |
| format | Article |
| id | doaj-art-2e3f0a005e714a978d3b963f3750b812 |
| institution | Kabale University |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-2e3f0a005e714a978d3b963f3750b8122025-02-03T07:24:02ZengWileyAdvances in Urology1687-63691687-63772021-01-01202110.1155/2021/47310134731013Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve CenterWaleed Mohamed Fadlalla0Ayman Hanafy1Mahmoud Abdelhakim2Hatem Aboulkassem3El Sayed Ashraf4Ahmed Abdelbary5National Cancer Institute, Cairo University, Department of Surgical Oncology, Cairo, EgyptNational Cancer Institute, Cairo University, Department of Surgical Oncology, Cairo, EgyptDepartment of Urology, Faculty of Medicine, Cairo University, Cairo, EgyptNational Cancer Institute, Cairo University, Department of Surgical Oncology, Cairo, EgyptNational Cancer Institute, Cairo University, Department of Surgical Oncology, Cairo, EgyptNational Cancer Institute, Cairo University, Department of Surgical Oncology, Cairo, EgyptBackground. Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. Methodology. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications. Results. LRC was associated with less hospital stay (9.8 vs. 13.8 days, P=0.001), less time to oral solid intake (6 vs. 8.6 days, P=0.031), and lower opioid requirements (23.3% vs. 53.3%, P=0.033). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable. Conclusion. Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.http://dx.doi.org/10.1155/2021/4731013 |
| spellingShingle | Waleed Mohamed Fadlalla Ayman Hanafy Mahmoud Abdelhakim Hatem Aboulkassem El Sayed Ashraf Ahmed Abdelbary Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center Advances in Urology |
| title | Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center |
| title_full | Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center |
| title_fullStr | Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center |
| title_full_unstemmed | Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center |
| title_short | Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center |
| title_sort | randomized controlled trial of laparoscopic versus open radical cystectomy in a laparoscopic naive center |
| url | http://dx.doi.org/10.1155/2021/4731013 |
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